What Is Ocular Herpes?

The typical lesions of eyelid shingles are mostly in the skin distribution area of the first branch of the trigeminal nerve (frontal nerve, lacrimal nerve and nasal ciliary nerve) or the third main branch (rarely), and clusters occur. Blister-like rash. It does not cross the central boundary of the eyelid and nose, but is limited to one side. Eyelid shingles is a more serious eyelid disease caused by chickenpox-shingles virus infection. More common in middle-aged and elderly patients. Rarely recurs after cure and is lifelong immunity.

Basic Information

English name

orbital herpes zoster

Visiting department

Ophthalmology

Multiple groups

Middle-aged and elderly

Common locations

eye

Common causes

Varicella-zoster virus infection

Common symptoms

Clusters of small transparent blisters, pustules, ulceration and erosion, dry crusts on the skin of the eyelids; chills, nausea, etc., fear of light, tears, redness and swelling of the skin, etc.

Causes of eyelid shingles

Caused by acute infection of the trigeminal hemilunar ganglia or one of its main branches. However, its violation mechanism is not fully understood, and it often occurs in frail elderly people. There is a distinction between recurrent and primary, the former is relatively rare. Shingles is divided into epidemic (viral) and symptomatic types according to the cause. The former may be caused by a chickenpox virus type infection. The latter is symptomatic herpes zoster.

Eyelid shingles clinical manifestations

1. There are different prodromal symptoms before onset, such as chills, nausea, and other general discomfort. A few days later, severe neuropathic pain appears in the ward, and there are symptoms such as fear of light, tears, and skin redness.

2. Clusters of small transparent blisters are formed on the eyelid skin, which are arranged in bands, followed by turbidity to form pustules, ulceration and erosion, and eventually dryness and crusting. The general course of disease is about 2 weeks. After exfoliation, the pigmentation is shallow. In the scar. In some cases, herpes and pus form deep ulcers with associated lymphadenopathy, leaving permanent scars after healing.

3. Herpes with a cluster of eyelid skin clusters, depending on the affected part of the first branch of the trigeminal nerve, usually appears in the first branch of the trigeminal nerve (ophthalmic nerve), covering the forehead and upper eyelid, and sometimes invading the second branch . The lesions are distributed on the face of the lower eyelid and the skin of the upper lip, and never cross the forehead midline. Neuralgia can last for 1 to 2 months, and sometimes disappear for several years, leaving a feeling of dullness and numbness after healing.

4. Herpes appears on the side of the nose and wings, often with corneal sensation, vision loss, corneal stroma turbidity, or even corneal ulcers, inflammation of the iris and ciliary body, and secondary glaucoma.

Eyelid shingles examination

1. Comprehensive eye examination

Including slit lamp examination and fluorescein staining, intraocular pressure measurement, mydriatic examination of the optic nerve and retina.

2. Whole body examination

Eyelid shingles diagnosis

1. Herpes trinidasis appears in the first and / or second branch of the unilateral trigeminal nerve, which does not exceed the midline of the face.

2. Herpes may be afraid of light, tears, severe pain along the nerves, local skin swelling, and general discomfort.

3. Herpes vary in size and are arranged in bands. It was colorless and transparent at first, followed by turbid purulence, and scabs fell off after about 2 weeks, leaving scars or pigmentation.

4. Conjunctivitis, keratitis, iridocyclitis often occur, and occasionally ophthalmoplegia.

Eyelid shingles treatment

1. Use antiviral drugs early

Such as high-concentration (35% to 40%) herpes net, dimethyl sulfide cotton tablets are topically applied for 3 to 4 days, which can shorten the course of disease and reduce sequelae. 1% cytarabine cream is applied topically or intravenously with cytarabine, while vitamin B ₁ and vitamin B ₁₂ are given at the same time. Ribavirin (ribavirin) is a broad-spectrum antiviral drug, which can be treated topically with a 0.5% solution or combined with oral administration with good results. Recently levamisole was taken orally.

2. Complicated keratitis or iridocyclitis

1% atropine solution can be used to dilate pupils to prevent adhesions behind the iris; topical application of antibiotics, antiviral eye drops and eye drops for nutritional cornea.

3. Hormones

Prednisone is taken orally, and the pain is reduced after the pain is reduced.

4. Analgesic

Those with severe pain can take compound aspirin, analgesic tablets, and indomethacin, which have a certain effect.

5. Improve body resistance

Intramuscular injection of placental globulin or gamma globulin and interferon prevents ocular complications and can shorten the course of treatment or inject with recovery period serum or blood.